Monday, July 30, 2018

To Keep Women From Dying In Childbirth, Look To California

Changes need to be made. "In 1950, the Journal of the American Medical Association, a beacon of medical research, made a dramatic claim: The battle to stop women from dying in childbirth had finally been won. "The Journal takes pride in announcing that for the first time in history the maternal mortality rate for a large nation — the United States of America — has been pushed slightly below the apparently irreducible minimum of one maternal death per 1,000 live births," an editorial proclaimed in an issue that year. Only a few other nations, it continued, could reach such stellar numbers: Sweden, Norway, Denmark, the Netherlands and New Zealand. In subsequent years, the rate of maternal death in the U.S., thought to be irreducible, fell even further. But then it stopped. "There was this premature declaration of victory," says obstetrician William Callaghan, chief of the Maternal and Infant Health Branch in the Division of Reproductive Health at the Centers for Disease Control and Prevention. Callaghan says that after the medical community declared victory, there was a shift in focus. "Into the late '60s and really through the '70s, the technology of being able to care for the fetus became huge," Callaghan says. "People became really enchanted with the ability to do ultrasound, and then high-resolution ultrasound, to do invasive procedures, to stick needles in the amniotic cavity, and everything did revolve around the baby." As the focus turned from mothers to babies, the trend lines for both diverged. Infant mortality is now at a "historic low," while the maternal mortality rate has continued to rise in recent years. Of the 700 to 900 maternal deaths each year in America, the CDC Foundation estimates that 60 percent are preventable. That's because, as NPR and ProPublica have reported, the American medical system still prioritizes infant survival over maternal care. It approaches childbirth with the assumption that most women who give birth will be fine."